• Title/Summary/Keyword: Patient-reported outcome measure

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Survey on Value Elements Provided by Artificial Intelligence and Their Eligibility for Insurance Coverage With an Emphasis on Patient-Centered Outcomes

  • Hoyol Jhang;So Jin Park;Ah-Ram Sul;Hye Young Jang;Seong Ho Park
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.414-425
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    • 2024
  • Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1-10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%-93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion: There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of non-clinical PCOs.

The Quality of Life after Lymphaticovenous Anastomosis in 118 Lower Limb Lymphedema Patients

  • Jin Geun Kwon;Yeongsong Kim;Min Young Jang;Hyunsuk Peter Suh;Changsik John Pak;Vaughan Keeley;Jae Yong Jeon;Joon Pio Hong
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.514-522
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    • 2023
  • Background This is a prospective study on 118 patients who underwent lymphaticovenous anastomosis (LVA) due to secondary lower limb lymphedema between January 2018 and October 2020 to evaluate patients' quality of life (QOL) using the Quality of Life Measure for Limb Lymphedema (LYMQoL) questionnaire. Methods The outcome measurement included the LYMQoL leg scoring system tool evaluating the function, appearance, symptom, mood, and overall outcome. In addition, correlation analysis was performed for three factors: based on International Society of Lymphology (ISL) stages, disease duration, and amount of volume reduction. Results The LYMQoL tool overall satisfaction score significantly increased at all intervals from 4.4 ± 0.2 preoperative to 6.5 ± 0.3 postoperative at 12 months (p < 0.001). Significant findings were seen for each domain scores compared preoperatively and at 12 months: function score (18.6 ± 0.5 to 15.4 ± 0.6), appearance score (17.8 ± 0.5 to 16.0 ± 0.6), symptom score (11.8 ± 0.3 to 8.9 ± 0.4), and mood score (14.5 ± 0.4 to 11.4 ± 0.5; p < 0.05). The correlation analysis between improvement of the overall score and the ISL stage (p = 0.610, correlation coefficient [r] = -0.047), disease duration (p = 0.659, r = -0.041), and amount of limb volume reduction (p = 0.454, r = -0.070) showed no statistical significance. Conclusion The QOL of secondary lower limb lymphedema patients was significantly improved after LVA regardless of the severity of disease, duration of disease, and amount of volume reduction after LVA. Understanding the patient-reported outcome measurement will help the surgeons to manage and guide the expectations of the patients.

Response Bias and Reliability of Patient Satisfaction Survey (환자만족도 조사의 응답편견과 신뢰도)

  • Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.3 no.2
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    • pp.83-88
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    • 2003
  • Patient satisfaction is now recognized as a outcome indicator of health care quality. The objective of this research was to evaluate a patient satisfaction survey instrument specially applicable to dental care, and to examines the reliability and the effect of response biases on reported satisfaction. The acceptability of satisfaction as a quality indicators was qualified by several measurement problems. The patient questionnaire was administered in four different study samples to examine the consistency of data. Cronbach's alpha was used as the measure of internal consistency. A aquiesent bias was found in the sample of 80(20%) respondents. Response biases affacted level of measured satisfaction. Highly acquiesent respondents were older, less well educated than nonaquiesent subject.

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Effect of Tailored Music Intervention on Intra-operative Anxiety among Those Undergoing Regional Anesthesia (환자의 선호도를 고려한 음악중재가 부분마취 환자의 수술 중 불안에 미치는 효과)

  • Kim, Joo Hee;Baek, Seol Hyang
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.1
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    • pp.187-198
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    • 2008
  • Purpose: Music intervention has long been used in research of patients undergoing surgical operation in reducing anxiety level and improve surgical outcome. However, there are few studies that have considered a patient's music preference. We investigated the effect of the tailored music intervention which chose music according to the patient's preference on anxiety level and vital signs. Method: The subjects were 50 patients who received regional anesthesia for surgical operation at D hospital in Pohang city from April, 2006 to November, 2006. All of the subjects were randomly assigned either music group (30 subjects) or non-music group (20 subjects). As the patients arrived in the operating room, vital signs were monitored until the subjects were transferred to the recovery room, while Spielberger's STAI-KYZ questionnaires were applied twice to measure preoperative and intra-operative anxiety. The data were analyzed by 2-test, t-test, one-way ANCOVA and repeated measures ANOVA using SPSS 12.0/PC+. Results: There were no significant differences between the two groups on vital signs. All of the vital signs increased when the subjects arrived in the operating room, but decreased quickly once the operation began, regardless of the groups. However, the music group reported significantly less intra-operative anxiety, compared to the non-music group (F=15.208, p<.000), when preoperative anxiety was treated as a covariance. Conclusion: The findings support that the use of music which was chosen by patients during the surgery significantly reduced patient's intra-operative anxiety during regional anesthesia.

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Effect of Complex Korean Medical Treatment on Spinal Epidural Hematoma: A Case Report

  • Youn Young Choi;Young Kyung Kim;Eun Sol Won;Chae Hyun Park;Hwa Yeon Ryu;Jae Hui Kang;Hyun Lee
    • Journal of Acupuncture Research
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    • v.40 no.1
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    • pp.78-89
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    • 2023
  • This paper presents the clinical outcome of an 82-year-old female who experienced sudden back pain combined with lower limb paresthesia and weakness after epidural steroid injection. The magnetic resonance imaging of the thoracolumbar spine showed a spinal epidural hematoma (SEH) extending from T8 to L4. She was treated non-operatively in the traditional Korean medicine (TKM) hospital. The patient's progress was assessed using the Numerical Rating Scale (NRS), American Spinal Injury Association (ASIS), Spinal Cord Independence Measure version III (SCIM III), and self-reported symptoms. During the 22-day hospitalization period,the NRS score decreased from 7 to 2 points, the motor score on the ASIS scale increased from 65 to 95 points. The subjective sense of lower extremities was felt by 1 increased to 8. The SCIM III score increased from 32 to 69 points. These results suggest that TKM could effectively reduce pain and aid the rehabilitation of patients with SEH.

Pulsed Radiofrequency Neuromodulation for Post-Stroke Shoulder Pain in Patients with Hemorrhagic Stroke

  • Doyoung Na;Mu Seung Park;Hyuk Jai Choi;Jinseo Yang;Yong-Jun Cho;Jin Pyeong Jeon
    • Journal of Korean Neurosurgical Society
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    • v.67 no.5
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    • pp.568-577
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    • 2024
  • Objective : Post-stroke shoulder pain (PSSP) is a common complication that limits the range of motion (ROM) of the shoulder, the patient's rehabilitation and in turn, affects the patients' quality of life (QoL). Several treatment modalities such as sling, positioning, strapping, functional electrical stimulation, and nerve block have been suggested in literatures, however none of the treatments had long-term effects for PSSP. In this study, the authors evaluated clinical efficacy of pulsed radiofrequency (PRF) neuromodulation on the suprascapular nerve for PSSP, and suggested it as a potential treatment with long-term effect. Methods : This retrospective case series was conducted at a single center, a private practice institution. From 2013 to 2021, 13 patients with PSSP underwent PRF neuromodulation of the suprascapular nerve. The primary outcome measure was the Visual analog scale (VAS) score. The secondary outcome measurements included the shoulder ROM, Disability assessment scale (DAS), modified Ashworth scale, modified Rankin scale (mRS), and EuroQol-5 dimension-3L questionnaire (EQ-5D-3L) scores. These parameters were evaluated before PRF modulation, immediately after PRF modulation, and every 3 months until the final follow-up visit. Results : Six men and seven women were enrolled, and all patients were followed-up for a minimum of 12 months. The mean VAS score was 7.07 points before PRF neuromodulation and 2.38 points immediately post-procedure. Shoulder ROM for abduction and flexion, DAS for pain, mRS, and EQ-5D-3L demonstrated marked improvement. No complications were reported. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective modality in patients with PSSP, and has long-term effect of pain relief, improvement of QoL.

Planning and Applying Simulation-based Practice for the Achievement of Program Outcomes in Nursing Students (간호학생의 학습성과 달성과 연계된 시뮬레이션 실습 설계와 운영)

  • Lim, Kyung Choon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.21 no.3
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    • pp.393-405
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    • 2015
  • Purpose: This study was conducted to plan and apply simulation-based practice for raising the achievement of program outcomes (POs) in nursing students. Methods: Using convenience sampling, 95 nursing students participated in this descriptive study. A self-reported questionnaire was used to measure the achievement of POs (self-directed learning, problem-solving ability, critical thinking) and usefulness of curriculum in addition to observing tracheal suction skills using a checklist. Results: A scenario with a pneumonia patient was developed to observe tracheal suction skills during simulation-based practices. Self-directed learning, problem-solving ability, and critical thinking were then scored. The mean scores of performance skill, self-directed learning, problem-solving ability, critical thinking were $37.82{\pm}6.03$. $3.61{\pm}0.38$, $3.61{\pm}0.33$, and $3.73{\pm}0.32$, respectively. All students passed the simulation-based practice in terms of performance ability and met the required achievement level for the POs at this university. Students with good suction skills showed significant differences in problem identification (p=.044) and alternative development (p=.019), which are components of problem-solving ability, compared to students with only fair skills. Conclusion: These findings indicate that simulation-based practice related to an adult nursing respiratory course was useful for evaluating the achievement of POs in nursing students. Further study is needed to develop a universal method of outcome measurement.

A Review of the Assessment Tools in Clinical Trials for Patients Injured in Traffic Accidents in South Korea (국내 교통사고 후유증 환자의 평가도구에 대한 임상연구 실태조사)

  • Jo, Hee Jin;Kwon, Min Soo;Kim, Jung Hwan;Jo, Dae Hyun;Choi, Ji Eun;Han, Ji Sun;Lee, Seung Min;Lee, Sang Hoon;Nam, Sang Soo
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.15-31
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    • 2016
  • Objectives : The aim of this study is to review the instruments used to assess patient condition and the effects of Korean medical treatment for patients injured in traffic accidents in clinical studies in the Korean medical field published in South Korea. Methods : A literature study was performed, and clinical studies on patients injured in traffic accidents visiting Korean medical clinics or hospitals were examined. Data about chief complaints, tools used to assess either patients' condition or the effectiveness of Korean medical treatment, and time point of assessment were extracted. The studies were classified according to symptom. The use-frequency and the parent category of the assessment tools were also analyzed. Results : 78 studies were selected and classified into 5 categories based on the chief complaints, neck pain, lower back pain, headache, psychological symptoms and unspecified symptoms. Various scales were used to report the patient's pain severity, and functional or psychological status resulting from traffic accidents. Pain index, in particular VAS, was most frequently used and a few mechanical instruments and Korean medicinal assessment tools were mentioned. Conclusion : Most instruments used in Korean medicine clinical studies on patients injured in traffic accidents are self-reported tools. To assess both the patient's condition precisely and the effectiveness of Korean medical treatment on patients injured in traffic accidents, more appropriate and unified tools should be designed that consider pain, functional disability, psychological status and objective assessments measured by devices together.

Anti-Obesity Effect of Panax Ginseng in Animal Models: Study Protocol for a Systematic Review and Meta-Analysis (동물실험에서 인삼의 항비만 효과: 체계적 고찰과 메타분석을 위한 연구 프로토콜)

  • Cho, Jae-Heung;Kim, Koh-Woon;Park, Hye-Sung;Yoon, Ye-Ji;Song, Mi-Yeon
    • Journal of Korean Medicine for Obesity Research
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    • v.17 no.1
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    • pp.37-45
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    • 2017
  • Recently the global epidemic problem of obesity has stimulated intense interest in the study of physiological mechanisms using animal models as a way to gain crucial data required for translation to human studies. Panax ginseng has been reported to have anti-obesity or antidiabetic effects in many animal studies; however, there have been few studies investigating human obesity. Herein, we will assess and examine the evidence supporting the anti-obesity effect of Panax ginseng in animal models with respect to anthropometric and metabolic outcomes. We will include controlled, comparative studies assessing the effect of Panax ginseng in preclinical studies of obesity. Panax ginseng will be administered during or following the induction of experimental obesity. The primary outcome measure will be anthropometric assessment and the secondary outcome measures will include adipose tissue weight, total amount of food consumed and metabolic parameters. We will search MEDLINE, Embase, PubMed, Web of Science, and Scopus without language, publication date, or other restrictions. Ethical approval will not be necessary as the data collected in this study will not be individual patient data, consequently there will be no concerns about violations of privacy. After finishing the whole procedure, the results will be disseminated by publication in a peer-reviewed journal or presented at a relevant conference. This protocol has been registered on the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) website (http://www.camarades.info).

Effects of Scalp Nerve Block on the Quality of Recovery after Minicraniotomy for Clipping of Unruptured Intracranial Aneurysms : A Randomized Controlled Trial

  • Seungeun Choi;Young Hoon Choi;Hoo Seung Lee;Kyong Won Shin;Yoon Jung Kim;Hee-Pyoung Park;Won-Sang Cho;Hyongmin Oh
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.652-663
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    • 2023
  • Objective : This study compared the quality of recovery (QoR) after minicraniotomy for clipping of unruptured intracranial aneurysms (UIAs) between patients with and without scalp nerve block (SNB). Methods : Patients were randomly assigned to the SNB (SNB using ropivacaine with epinephrine, n=27) and control (SNB using normal saline, n=25) groups. SNB was performed at the end of surgery. To assess postoperative QoR, the QoR-40, a patient-reported questionnaire, was used. The QoR-40 scores were measured preoperatively, 1-3 days postoperatively, at hospital discharge, and 1 month postoperatively. Pain and intravenous patient-controlled analgesia (IV-PCA) consumption were evaluated 3, 6, 9, and 12 hours and 1-3 days postoperatively. Results : All QoR-40 scores, including those measured 1 day postoperatively (primary outcome measure; 155.0 [141.0-176.0] vs. 161.0 [140.5-179.5], p=0.464), did not significantly differ between the SNB and control groups. The SNB group had significantly less severe pain 3 (numeric rating scale [NRS]; 3.0 [2.0-4.0] vs. 5.0 [3.5-5.5], p=0.029), 9 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.048), and 12 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.035) hours postoperatively. The total amount of IV-PCA consumed was significantly less 3 hours postoperatively in the SNB group (2.0 [1.0-4.0] vs. 4.0 [2.0-5.0] mL, p=0.044). Conclusion : After minicraniotomy for clipping of UIAs, SNB reduced pain and IV-PCA consumption in the early postoperative period but did not improve the QoR-40 scores.